I expect a lot of people will have seen the piece about the closure of the beds at Torrington Hospital on BBC Southwest. There’s also a piece about it on the BBC web site.
I’m at the bottom left of the picture of the meeting. My head can’t be seen, but that is me with the laptop – one of the very few times it’s actually been on my lap!
STITCH (Save The Irreplaceable Torrington Cottage Hospital) campaigners were out in force. They’re the people you can see on the BBC web site occupying the whole of the second row and part of the front row.
Unfortunately the STITCH campaigners are very strong on emotion but very week on facts. Their spokeswoman on the BBC Southwest news item said quite clearly that the CCG (Clinical Commissioning Group) had totally ignored what STITCH had to say. They didn’t ignore it at all. Quite the reverse, they spent a great deal of time looking at the STITCH evidence and investigating it (the CCG documents can be found here).
Of course people feel passionately about their community hospital, but time has moved on and standalone ten-bedded units are exceedingly difficult to justify in today’s environment.
They’re difficult to justify on grounds of cost, and, far more importantly, they’re difficult to justify on health grounds.
When most community hospitals were founded (the Torrington hospital in 1908, South Molton even earlier, in 1897) there was no NHS and health care was very, very different. Community hospitals (or cottage hospitals as they used to be called) were very necessary indeed and acted like smaller, local equivalents of the current North Devon District Hospital.
There was far less technology involved, and far fewer different medical, nursing and ancillary specialisms. Treatments were also far simpler. For example, X-Rays were first discovered in 1895, blood transfusion techniques were properly started during the First World War in 1917, hip replacement first started in the 1950’s and 60’s (in the UK!).
In addition life expectancy has risen dramatically: in 1900 it was about 47 for a man and about 50 for a woman, in the 1930s it was about 60 for a man and by 1950 had risen to 65. It now stands at about 77 for men and 81 for women. This has bought about a change in the types of medical issues that people face, and the number of issues that individuals, particularly the elderly, face.
A lot of treatment, whether medical or surgical, has thus become more complex. Whereas some has become simpler and easier to administer – surgery that once would have entailed a lengthy hospital stay can now be safely performed quickly and easily as a day case.
The days of the District Nurse on a bicycle are also long gone. With cars, mobile phones, laptop computers and inexpensive equipment for measuring things like blood oxygen levels, blood pressure, blood sugar levels etc. the range of medical issues that can be treated in the home has expanded considerably.
Of course it would be fantastic if everybody could have hospital treatment a short distance from home or if there were an A&E department in every small town. But the money just isn’t there, neither is the requisite number of skilled staff, and people do prefer to be treated at home.